Treatment of dependence upon stimulants and hallucinogens

Abstract

Phencyclidine (PCP), cocaine, marijuana and amphetamine dependence has emerged in recent years to be a chronic, endemic problem in many Western countries. Ten years ago when this Journal was conceived, there was little interest in the treatment of stimulant and hallucinogenic drug dependence. Heroin and alcohol abuse were the prominent, essentially uncontrolled problems of the day that had to be addressed. The wide-scale use of lysergic acid diethylamide (LSD), methamphetamine and methylphenidate, witnessed in the 1960’s and early 1970’s had passed without any specific therapies being developed for the dependent person [ 11. Treatment was so ineffective at this time that Anderson et al. [2] reported in 1972 that only 8 of 136 patients with amphetamine and hallucinogenic dependence returned for even one repeat clinic visit after being admitted to a structured treatment program. Although a decade has passed, treatment for stimulant and hallucinogen dependence remains elusive. For example, recent editions of major medical and psychiatric textbooks list no specific treatment for amphetamine, cocaine, PCP or cannabis dependence, although a variety of remedies are available for overdoses and drug-induced psychosis [3,4].